Spinal Extradural Arachnoid Cyst Causing Cord Compression in a 15-Year-Old Girl: A Case Report

Abstract

The authors describe the case of a fifteen-year-old girl with progressive paraparesis of the lower limbs that was caused by an intraspinal extradural dorsal arachnoid cyst at the level of Th 3-6. Diagnosis was established with MRI and MRI myelography. The latter revealed the CSF-like content of the cyst. The patient underwent laminotomy and en bloc resection of the cyst. Ligation of the pedicle of the cyst was done with laminoplasty. Quick and complete recovery was observed after surgery.

Zusammenfassung

Die Autoren beschreiben den Fall eines 15-jährigen Mädchens mit progressiver Paraparese, die durch eine extradurale dorsale intraspinale Arachnoidalzyste auf dem Niveau Th 3 bis 6 verursacht ist. Die Diagnose wurde durch MRl und MR-Myelographie gesichert. Letztere zeigte den wassergleichen lnhalt der Zyste. Nach Laminotomie und en bloque Resektion der Zyste ist der Pedikel der Zyste reseziert worden, und eine Laminoplastik schloss den Eingriff ab. Nach der Chirurgie trat eine schnelle und komplette Erholung ein.

Key words

Spinal cyst - extradural - cord compression

SchIüsselwörter

Spinale Zyste - Rückenmarkkompression - Arachnoidalzyste

References

• 1 Congia S, Coraddu M, Tronci S, Nurchi G, Fiaschi A. Myelographic and MRI appearances of a thoracic spinal extradural arachnoid cyst of the spine with extra- and intraspinal extension.  Neuroradiology. 1992;  34 444-446
• 2 Ersahin Y, Yildizhan A, Seber N. Spinal extradural arachnoid cyst.  Childs Nervous System. 1993;  9 250-252
• 3 Gortvai P, Chir M, El-Gindi S. Spinal extradural cyst. Case report.  J Neurosurg. 1967;  26 432-435
• 4 Gray L, Djang W T, Friedman A H. MR imaging of thoracic extradural arachnoid cysts.  J Comput Assist Tomogr. 1988;  12 646-648
• 5 Hatashita S, Kondo A, Shimizu T, Kurosu A, Ueno H. Spinal extradural arachnoid cyst - case report.  Neurol Med Chir (Tokyo). 2001;  41 318-321
• 6 Karadereler S, Orakdögen M, Kilic K, Özdogan C. Primary spinal extradural hydatid cyst in a child: case report and review of the literature.  Eur Spine J. 2002;  11 500-503
• 7 Kim K S, Weinberg P E. Magnetic resonance imaging of a spinal extradural arachnoid cyst.  Surg Neurology. 1986;  26 249-252
• 8 Krings T, Lukas R, Reul J, Spetzger U, Reinges M HT, Gilsbach J M, Thron A. Diagnostic and therapeutic management of spinal arachnoid cysts.  Acta Neurochir (Wien). 2001;  143 227-235
• 9 Miravet E, Sinisterra S, Birchansky S, Papazian O, Tuite G, Grossman J A, Alfonso I. Cervicothoracic extradural arachnoid cyst: possible association with obstetric brachial plexus palsy.  J Child Neurol. 2002;  17 770-772
• 10 Myles L M, Gupta N, Armstrong D, Rutka J T. Multiple extradural arachnoid cysts as a cause of spinal cord compression in a child. Case report.  J Neurosurg. 1999;  91 116-120
• 11 Nowak D A, Lucking M O, Bohmer R H, Schreiner R, Fuchs H H, Flugel K A. Isolated intracerebral cystic echinococcosis. Unusual presentation of a rare disease.  Dtsch Med Wochenschr. 2002;  127 1638-1642
• 12 Prevo R L, Hageman G, Bruyn R P, Broere G, van de Stadt J. Extended extradural spinal arachnoid cyst: an unusual cause of progressive spastic paraparesis.  Clinical Neurology & Neurosurgery. 1999;  101 260-263
• 13 Rabb C H, McComb J G, Raffel C, Kennedy J G. Spinal arachnoid cysts in the pediatric age group: an association with neural tube defects.  J Neurosurg. 1992;  77 369-372
• 14 Rimmelin A, Clouet P L, Salatino S, Kehrli P, Maitrot D, Stephan M, Dietemann J L. Imaging of thoracic and lumbar spinal extradural cysts: report of two cases.  Neuroradiology. 1997;  39 203-206
• 15 Shih D Y, Chen H J, Lee T C, Chen L. Congenital spinal arachnoid cysts: report of 2 cases with review of the literature.  J Formos Med Assoc. 1990;  89 588-592
• 16 Vallée B, Mercier P h, Menei P h, Bouhour F, Fischer C, Fournier D, Bougeard R, Diabira S, Mahla K. Ventral transdural herniation of the thoracic spinal cord: surgical treatment in four cases and review of the literature.  Acta Neurochir (Wien). 1999;  141 907-913